Surgical Management of Lower Urinary Tract

Symptoms Attributed to Benign Prostatic Hyperplasia

SURGICAL THERAPY

Large
Assessment of Prostate Size • Simple Prostatectomy
Prostate
• HoLEP
• ThuLEP

• Aquablation1 • TURP Size Independent Options

• HoLEP • TUVP
Average • PVP • Water Vapor
Prostate • PUL2 Thermal
• ThuLEP Therapy3 • HoLEP • ThuLEP
• TUMT

• Aquablation1 • TUMT Eligible patients who desire

• HoLEP • TURP preservation of erectile and
Small • PVP • TUVP ejaculatory function may be
Prostate • PUL2 • Water Vapor offered PUL or water vapor
• ThuLEP Thermal thermal therapy as data indicate
• TUIP4 Therapy3 that both therapies provide a
greater likelihood of preservation
of sexual function.

MEDICALLY COMPLICATED PATIENTS

In patients who are at higher risk of bleeding, such as those on anticoagulation drugs,
therapies with a lower need for blood transfusion, such as HoLEP, PVP and ThuLEP, should
be considered. For additional information on the use of anticoagulation and antiplatelet
therapy in surgical patients, refer to the ICUD/AUA review on Anticoagulation and
Antiplatelet Therapy in Urologic Practice.

1
Eligibility for an aquablation procedure is dependent upon prostate volume >30/<80g.
Eligibility for a PUL procedure is dependent upon absence of obstructing midline prostate tissue
2

and prostate volume <80g

Eligibility for a Water Vapor Thermal Therapy procedure is dependent upon prostate volume <80g
3

4
Eligibility for a TUIP procedure is dependent upon prostate volume <30g